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The referendum was initially suggested by Morales in December 2007, but was rejected by the opposition at the time. However, the opposition-controlled Senate brought back the suggestion following their victory in the Santa Cruz autonomy referendum on 4 May 2008, with Morales agreeing to hold the vote.

The recall election would be deemed successful if the percentage voting in favour of the recall exceeded the percentage of voters that originally voted for the person. For Morales and Linera, there would have to be more than 53.74% (their margin in the 2005 presidential election). The same rules apply for the governors, but their margins are between 48% and 38% in La Paz Department which makes their recall much easier to accomplish.[2][3] If the recall is successful then fresh elections would be held.[4] Morales has stated that if he stays in office, he will use the referendum result as a springboard for more reforms – for instance, setting a date for the constitutional referendum which would grant more rights to Bolivia's poor indigenous population.[5] If he loses, he said he would go back to farming coca.[2]

Following autonomy referendums held in the second quarter of 2008 in Santa Cruz, Beni, Pando and Tarija, the governors of these four states initially refused to take part in the recall referendum unless the referendum complied with the new autonomy statutes, which the Supreme Electoral Court considers to be invalid; they pushed for early elections to be held instead.[7] Nonetheless, the governors later agreed to participate.[8] However, there were still obstructive measures from these four departments a few days before the referendum.[9]

Shortly before the election, the rules were changed, though the legality of this move remains in doubt; under the new rules, the governors will be removed from office if over 50% of voters recall them, effectively raising the threshold required.[12]